Infection Prevention and Control Knowledge, Attitudes, and Practices of Healthcare Workers in Tertiary Care Hospitals in Bangladesh During Coronavirus Disease 2019: A Multicenter Cross-sectional Survey.

BACKGROUND

Healthcare workers (HCWs) play a pivotal role in preventing healthcare-associated infections by adhering to infection prevention and control (IPC) practices. This study assessed IPC knowledge, attitudes, and practices (KAP) among HCWs at tertiary care hospitals in Bangladesh during the coronavirus disease 2019 pandemic.

METHODS

From September 2020 to January 2021, semistructured questionnaires were administered to physicians, nurses, and cleaning staff at 11 tertiary care hospitals in Bangladesh. KAP components were classified into "good," "fair," and "poor" based on the frequency of favorable responses (>75%, 50%-75%, <50%). Multivariate logistic regression was used to assess the relationship between knowledge, attitudes, and self-reported practices.

RESULTS

We enrolled 1728 HCWs, including 526 physicians (30.4%), 934 nurses (54.1%), and 268 cleaning staff (15.5%). Physicians and nurses demonstrated "good" IPC knowledge (median 94.8% and 96.6% favorable responses, respectively) and self-reported IPC practices (median 76.2% and 80.4% favorable responses). However, most cleaning staff exhibited "poor" IPC knowledge (median 47.3% favorable responses) and practices (21.3% favorable responses). Across all categories of HCWs, the median attitude score was "fair" (range 60.0%-71.2% favorable responses). Having a positive attitude toward IPC was associated with increased IPC knowledge (adjusted odds ratio 3.0, P < .001) and good IPC practices (adjusted odds ratio 16.3, P < .001).

CONCLUSIONS

HCW's KAP toward IPC was found to be suboptimal, especially among cleaning staff. However, the strong association noted between favorable attitudes toward IPC and adherence to safe IPC practices demonstrates the need for hospital leadership to promote a positive IPC culture, in addition to training and resources, to improve IPC practices and enhance healthcare resiliency beyond the coronavirus disease 2019 pandemic.